Necrotising Fasciitis – Cellulitis Complications

Necrotising fasciitis can be a complication of cellulitis. In this article we take a closer look at both conditions.

What is cellulitis?

Cellulitis is a bacterial infection of the deeper layers of skin, usually the deeper dermis and subcutaneous fat. Cellulitis happens when bacteria (or rarely fungi) get through a break in the skin and travel down to the deeper layers of dermis and fat.

Streptococcal and staphylococcal infections are usually responsible for cellulitis. For the infection to occur, the bacteria must be presented with an opportunity to enter the body. Normally this will be through a break in the skin, such as a surgical wound, an ulcer or a needle-stick injury.

When cellulitis arises, the area of skin will become red, hot to touch and swollen. Cellulitis can appear anywhere in the body although it is more common in the legs. The patient may also report feeling unwell with flu-like symptoms and sometimes blisters can appear on the skin.

These symptoms are indicative of cellulitis and a GP should be able to diagnose the condition relatively easily. Antibiotics should be prescribed to treat the condition. If caught in time, cellulitis can be treated at home and the patient will make a speedy recovery.

Complications of cellulitis

However, it is possible that the bacteria will spread to an ever greater area. If the bacteria do spread to the muscles, subcutaneous tissue or blood, the patient will become extremely unwell.

Symptoms that should provoke concern include:

Vomiting

Growing area of redness

High temperature

Rapid heart rate

Fast, shallow breathing

Confusion or changes in mental state

If these symptoms develop, the patient needs treatment in hospital. This is because the patient may be experiencing a complication of cellulitis, which include the following:

Meningitis

Abscess

Sepsis

Necrotising fasciitis

Meningitis, sepsis and necrotising fasciitis are particularly problematic as they are all life-threatening conditions.

What is necrotising fasciitis?

Necrotising fasciitis is also a bacterial infection that is frequently caused by the streptococcal or staphylococcal organisms. But unlike cellulitis, the infection affects the deeper layers of tissue and fascia (connective tissue).

Necrotising fasciitis can occur on its own, or as mentioned above, it can develop secondary to another infection such as cellulitis. When necrotising fasciitis happens as a result of cellulitis, it means the bacteria have travelled further down into the deeper tissues.

Necrotising fasciitis is a severe infection because it quickly causes the tissue to die. Due to the proximity of the blood vessels, the bacteria can also easily spread to the blood from the deep tissues. This is very dangerous as the patient will suffer a septic inflammatory response. Clots and inflammation will appear across the body (sepsis), preventing the flow of blood (septic shock). The patient's blood pressure will drop and the organs will become deficient in oxygen. This can lead to organ failure and death.

Diagnosing and treating necrotising fasciitis

Because necrotising fasciitis is a potentially fatal condition, it must be recognised and treated without delay. Treatment must involve intravenous antibiotics and surgical debridement. Thus a patient must be admitted to hospital, and will probably even require a spell on the Intensive Care Ward.

All of the necrotic tissue must be surgically removed or the infection will remain in the body. If necrotising fasciitis has not been quickly diagnosed, the amount of tissue necrosis can be extensive. A whole limb may have to be amputated.

Failure to diagnose and treat

If medical practitioners fail to diagnose and treat necrotising fasciitis, there could be grounds for a medical negligence compensation claim.

Furthermore, there may be a case if medical practitioners failed to diagnose and treat cellulitis, thereby causing the patient to suffer the complication of necrotising fasciitis. Indeed, had the patient's cellulitis been recognised and antibiotics given, it would have been successfully cured. This would be prevented the patient from developing necrotising fasciitis at all.

Necrotising fasciitis mistaken for cellulitis

There can also be grounds for a claim if necrotising fasciitis is mistaken for cellulitis. The two conditions are very similar and the symptoms are almost identical. However, necrotising fasciitis will be all the more severe, with fever and extreme tissue pain. The patient will also deteriorate rapidly and will display obvious skin changes, particularly black necrotic tissue. This clearly differentiates necrotising fasciitis from cellulitis.

If medical practitioners fail to notice the obvious signs of necrotising fasciitis, instead treating a patient as though he/she has cellulitis, there may be a breach of duty. If so, this will entitle the patient (or their family) to make a claim.

Expert legal advice

To find out more about claiming compensation for necrotising fasciitis, please do not hesitate to get in touch with us at Glynns Solicitors. We are a specialist clinical negligence law firm and help victims of medical error obtain the justice they deserve. We are based in between Bath and Bristol but act for clients across England and Wales.

We offer a free initial consultation, during which you will have the chance to discuss your potential claim with a legal expert. After this telephone conversation, we will advise whether or not you are able to pursue litigation. The claim may relate to yourself, or your loved one. If your loved one has died, is under the age of 18 or lacks capacity, you can make the claim on their behalf.

What does it cost?

We offer a range of funding arrangements. Most of our claims are run on a 'no win no fee' basis, which means we do not get paid if the claim is unsuccessful. If the claim is successful, we are allowed to take a success fee, but this will come directly from the compensation settlement.

We will explain the options in greater detail when we speak on the phone, but you should be rest assured that you will enjoy significant financial protection when making a claim. You will not have to pay anything if you lose. You may have to pay a success fee if you win, but this is capped at 25% of the compensation settlement.

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